By Taylor Smith 

Photography by Tom Grimes

The youngest son of Massachusetts Senator Ted Kennedy and Virginia Joan Kennedy, Patrick Kennedy has put down roots in Brigantine, New Jersey with his wife, Amy, and four children, Harper, Owen, Nora, and Nell. Amy is expecting their fifth child in May. A New Jersey native, Amy has more than 15 years’ experience working in New Jersey public schools and is the education director of The Kennedy Forum. Patrick lovingly refers to Amy as his “Jersey girl,” who grew up in a neighboring shore town. Located on the bayside of the Jersey Shore, a stone’s throw from Atlantic City, the Kennedy’s waterfront home is centered around family and the beauty of the natural setting. On the day of Princeton Magazine’s visit, seagulls were dive-bombing around Patrick’s boat and fine grains of sand blew across the roadway.

Former congressman (D-Rhode Island), founder of The Kennedy Forum, co-founder of One Mind, and commissioner of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, Kennedy continues to fight to end discrimination against mental illness, addiction, and other brain diseases. He may be best knownas the lead sponsor of the Mental Health Parityand Addiction Equity Act, which was passed in 2008 during George W. Bush’s presidency. The law requires most health insurance plans to provide coverage for mental illness and addiction in the same way that diseases of the body are treated.

Founded in 2013, The Kennedy Forum is a nonprofit organization whose mission is to lead a national dialogue on transforming mental health and addiction care delivery. The Forum also aims to achieve health equity by advancing evidence- based practices, policies, and programming in mental health and substance use.

The co-founder of One Mind, Kennedy hopes to pioneer a greater global investment in cures for diseases of the brain. Current initiatives are exploring treatments and cures for post-traumatic stress and traumatic brain injury. One Mind also addresses diagnostic research and treatment for Alzheimer’s disease, Parkinson’s disease, ALS, addiction, and depression.

Inspired by his political work and family history, in 2015 Kennedy co-authored theNew York Times bestseller, A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction. In the book, Kennedy detailed his own struggles with bipolar disorder and drug abuse. He writes, “I grew up among people who were geniuses about not talking about things.”

In 2017, Kennedy was appointed to serve on the President’s Commission on Combating Drug Addiction and the Opioid Crisis, which is chaired by former New Jersey Governor Chris Christie. The Commission studies ways to combat and treat the impact of drug addiction in the U.S. In a final report of recommendations to President Donald Trump, Kennedy focused on the declaration of a federal emergency.

Kennedy spoke with Princeton Magazine about his continued work and leadership in mental health advocacy, brain research, addiction treatment, and his life in New Jersey.

How does affordability within the state of New Jersey relate to mental health care and addiction treatment?

Affordability is, of course, an important aspect to effective mental health and addiction treatment. However, I think the real issue is not so much the cost of health insurance, but what happens when you have health insurance and still cannot get adequate care because your insurance plan refuses to cover treatment or forces you out of an inpatient facility after a very limited stay. Additionally, many insurance plans only cover one of the three FDA-approved medications for treatment of opioid use disorder. What ends up happening is that people are paying for these health insurance policies—thinking they are covered— but when the rubber meets the road, they feel hung out to dry. That’s why we have to enforce the Federal Parity Law, so that individuals and small business owners actually get what they pay for when they purchase insurance. The Kennedy Forum created a website called Parity Track, where consumers and policymakers can track legislative, regulatory, and legal parity activities in all 50 states and at the federal level to monitor implementation and best practices. I encourage everyone to get involved and get educated on parity. It is critical to improving access to mental health care and addiction treatment, in New Jersey and nationwide.

What is the current state of the opioid crisis in New Jersey and how is it different from (or similar to) other states?

In New Jersey alone, one person dies every 48 hours from an opioid overdose. We are taking an aggressive approach to fighting the opioid epidemic—one of the strongest in the nation. That’s because New Jersey is utilizing a wide array of evidence-based solutions. This differs greatly from the ineffective one-size-fits-all approach that some states are taking.

Thankfully, Governor Christie recognized the opioid epidemic as a dire public health crisis and acted accordingly. The state dedicated $200 million in new dollars to fight the crisis late last year. I am confident that Governor Murphy will build upon the strong foundation of support left by Governor Christie.

In fact, Governor Murphy’s Healthcare Committee, of which I am a member, has already recommended a series of key actions to keep New Jersey moving forward. We called for comprehensive public education campaigns—targeting users, prescribers, caregivers, and drug courts—designed to address death risks, needle exchange programs, prescription monitoring efforts, medication- assisted treatment, and more. Often, New Jersey’s regulatory systems unnecessarily frustrate the implementation of integrated clinical care, leading to a real shortage of appropriate care for those in crisis, and for those whom crisis could be avoided. This could be addressed through a plan to clear applications for integrated behavioral care within six months; a listening tour to explore behavioral health regulatory reform with advocates, caregivers, consumers, and community health organizations; a dedicated workgroup to update and rationalize payment and licensing policy; and an inventory of service providers from acute detox to community support to facilitate referrals and planning, including for hard-to-reach groups such as pregnant women and reentering prisoners.

Medical groups in our state are also making great strides in combating the opioid crisis. Riverside Medical Group, for example, is using a fully-integrated model of primary care and mental health in the same offices, all under one roof. They work from one shared electronic medical record system, which means providers have access to hospital, specialty, and primary care records. This goes a long way in helping to stop accidental opioid prescribing to those with substance use disorder. In addition, they monitor prescribing rates and conduct analysis of historical claims and clinical data to predict patients with potential opioid abuse, use special questionnaires to screen patients annually for addictions, and use quality measures to monitor the initiation and engagement of alcohol and other drug dependence treatment. All of these initiatives are making a difference.

What prompted you to write A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction, and was it a difficult book to write?

I struggled with bipolar disorder and addiction for a very long time, often in the public eye. I wanted to address the elephant in the room head on. Almost every family in this country is touched by mental illness or addiction, yet no one talks about it. Why? Because people still treat mental illness and addiction like a moral failing or character flaw instead of brain diseases. That has to change.

Perhaps most important, I also wanted to outline a clear path forward for a better mental health care system and the policy needed to support it. Honestly, I was sick and tired of the anti-stigma campaigns.The real way to change attitudes is to change practices. Right now, we often wait until someone has a crisis before starting treatment for mental illness or addiction. But we don’t treat diabetes or cardiovascular disease that way. Full implementation of the Federal Parity Law, which requires insurers to treat illnessesof the brain, such as depression and addiction, the same way they treat illnesses of the body, such as diabetes and cancer, is absolutely critical. I didn’t write this book for me. Dredging up the past doesn’t serve me. I received a lot of pushback and I was ridiculed for it—all expected. The book was my attempt to advance an important cause, speak up for others who haven’t yet found their voice, and provide a road map for getting us to a better place as a nation.

How has fatherhood and your current work shaped your recovery?

My work in mental health advocacy certainly helped lead me toward recovery, but my recovery is truly possible because of the strong personal connectionsI have in my life—especially with my beautiful wife, Amy, and our children. Being a father has strengthened my commitment to recovery for obvious reasons, but it has also strengthened my commitment to fighting for mental health equity and justice in this country. I want my children to grow up in a world where there is no more discrimination against those with mental illness or addiction, and diseases of the brain are treated just like diseases of the body. If they need help, or their children need help, I hope they can seek that help without second thought in a system built around integrated care. I want that for everyone.

My long-term recovery is also shaped by the inspiring people I meet out on the road or through my work with The Kennedy Forum. The resiliency and authenticity I witness first-hand just goes to show what we are truly capable of when we choose to walk the walk in a life of recovery.

Describe the purpose behind Quartet.

Forty-two million people in our country live with co-occurring physical and mental health conditions—and 60 percent of them receive no help for the latter. This disconnected system not only hurts patients, it hurts providers. Doctors often have to cram complex chronic disease management into seven-minute appointments. Empowered by provider data, Quartet’s innovative digital platform uses algorithms to proactively identify patients who are in need of care for underlying, untreated mental health conditions. Quartet then bridges the gap between physical and mental care by connecting those patients with mental health providers or online therapy based on their unique needs, insurance, and location.

I am so proud to be on Quartet’s board. Promoting the use of technology to improve our mental health care system has always been a key pillar of my work as an advocate, because relying solely on face-to-face care is just not realistic. Quartet is shining a much-needed spotlight on what’s possible when health systems and insurers prioritize true, integrated care. This year, they are embarking on a partnership with Horizon Blue Cross Blue Shield of New Jersey, one of the largest health insurers in the state. Great things are to come.

Please comment on Governor Phil Murphy’s vow to expand access to medical marijuana in New Jersey.

I don’t think anyone should be arrested for possessing marijuana and saddled with a criminal record. But I also don’t think legalization or commercialization is the answer. That’s why I support Senators Rice and Singer in their attempt to decriminalize possession, while keeping sales of elixirs and edibles illegal. We don’t need more stoned drivers or kids using THC gummies. How would that make New Jersey stronger? I think we’ve gotten caught up in this false dichotomy between legalization or criminalization. That’s one of the reasons I helped to start Smart Approaches to Marijuana (SAM) with a former Obama appointee. SAM also has a New Jersey affiliate— NJ Responsible Approaches to Marijuana Policy (NJ-RAMP)—that I wholeheartedly support.

As for expanding medical marijuana, we need to wait and see what the details are. We shouldn’t be in a hurry to turn Atlantic City into Venice Beach, where “docs for hire” sell pot recommendations to anyone with a headache for $100 cash. That said,I support research into marijuana’s medical components and following the lead of the FDA. I think there will be some marijuana-based CBD medications approved by the FDA later this year, and that could be very helpful to many people. I’m less thrilled about medicine via gubernatorial decree, but again, I think we should wait for details of the new plan.

What is your favorite thing about living at the Jersey Shore?

Sailing, taking the kids tubing or swimming in the ocean or bay, spending the day at the beach—these things make me very happy. I am blessed to have the opportunity to share my love of the water with my wife and children on the beautiful Jersey Shore. We take full advantage of our surroundings. The people are friendly and good-hearted, just like the Jersey girl I married!

Describe some current personal or professional projects that you are most excited about.

New Jersey holds great potential for realizing full implementation of the Federal Parity Law. Just last year, advocates pushed for a bill that made it easier for substance use disorder (SUD) patients to access care. That bill, which was passed and signed into law, specifically limits situations in which insurers may deny claims/deny coverage for outpatient and inpatient SUD benefits.

The Kennedy Forum is now actively working with those advocates to build upon the bill’s success. In 2017, legislation was introduced that aimed to better regulate insurers’ compliance with the Federal Parity Law. Not only did the bill require insurance plans to submit reports to the state jurisdiction proving their compliance, but it also mandated that regulators report on their efforts to enforce existing state laws and the Federal Parity Law. This is a great step forward in making sure New Jersey residents will be able to get the care they need when they need it.

The Kennedy Forum engages in similar work across the nation by introducing parity implementation legislation and providing technical assistance to state and federal regulators. We work on Capitol Hill to educate members of Congress on mental health/SUD issues and advance evidence-based policy solutions as outlined in our Guide for the 115th Congress and the final recommendations of The President’s Commission on Combating Drug Addiction and The Opioid Crisis, on which I served.

Our most recent work has been focused on how to best appropriate funding to address the devastating opioid crisis, bringing SUD patient health record provisions into alignment with the rest of medicine, and bettering suicide prevention efforts among vulnerable populations.

Of course, I am always excited about The Kennedy Forum’s powerful parity tools: Parity Registry and Parity Track. We are constantly refining these websites to empower individuals, families, policymakers, journalists, and others in fighting for parity rights. On Parity Registry.org, consumers can learn to file an appeal with their health plan after being denied coverage for mental health or addiction treatment services, send a complaint directly to state enforcement officials, access step-by-step appeals guidance, and more. ParityTrack.org is a website where anyone can track legislative, regulatory, and legal parity activities in all 50 states and at the federal level to monitor implementation and best practices.